Corporate 100 County Road B Shawano, USA
5 days ago
RN Care Manager (Utilization Review/Rural Care Mngmnt)

Why ThedaCare?   

Living A Life Inspired!

Our new vision at ThedaCare is bold, ambitious, and ignited by a shared passion to provide outstanding care. We are inspired to reinvent health care by becoming a proactive partner in health, enriching the lives of all and creating value in everything we do. Each of us are called to take action in delivering higher standards of care, lower costs and a healthier future for our patients, our families, our communities and our world. 

At ThedaCare, our team members are empowered to be the catalyst of change through our values of compassion, excellence, leadership, innovation, and agility.  A career means much more than excellent compensation and benefits. Our team members are supported by continued opportunities for learning and development, accessible and transparent leadership, and a commitment to work/life balance. If you’re interested in joining a health care system that is changing the face of care and well-being in our community, we encourage you to explore a future with ThedaCare.

Benefits, with a whole-person approach to wellness –

Lifestyle Engagemente.g. health coaches, relaxation rooms, health focused apps (Wonder, Ripple), mental health support  

Access & Affordabilitye.g. minimal or zero copays, team member cost sharing premiums, daycare

About ThedaCare!

Summary :The RN Care Manager is responsible for coordination of multiple disciplines and resources to facilitate transition of the patient to the appropriate level on the continuum of care. Develops a plan of care to ensure the highest quality care with the best outcomes for the patient in the most cost-effective manner. Integrates decisions of committees into the operation and activities of the department.

Job Description:

KEY ACCOUNTABILITIES:

Utilizes nursing process, evidenced-based practice, and unit-specific competencies to complete an accurate and timely assessment of the patient’s needs, goals, preferences, and resources available.

Facilitates the development of a plan of care in collaboration with the patient, family, caregiver, and health care team. Determines the appropriate level of care and coordinates the interdisciplinary treatment and plan of care.

Arranges appropriate and prompt access to care transition needs, primary care providers, physician specialists, and similar services/equipment as necessary.

Evaluates progress toward the goals/expected outcomes of the plan, facilitates the progression of care, and ensures revisions in response to changes in patient needs and condition. Proactively identifies, communicates, and resolves barriers that impede the progression of care.

Communicates information effectively to the health care team, patient, caregivers/families, and those involved in the treatment and patient’s care.

Advocates on behalf of patients/families and caregivers for service access and insurance benefits allowing informed choice within the constraints of regulations, and for the protection of the patient’s health, safety, and rights.

Evaluates the options available and balances cost and quality to ensure the optimal clinical and financial outcomes.

Collaborates with multiple disciplines internally and externally to effectively and efficiently identify and provide available community resources/potential partners, and advocates for resolution of gaps in the available resources.

Collaborates with managers, physicians, medical directors, advisory groups, and treatment teams for issues related to physician practices and best practices for the patient’s plan of care.

QUALIFICATIONS:

Bachelor’s of Science in Nursing (BSN)

Current Wisconsin RN License

American Heart Association Healthcare Provider Basic Life Support (BLS)

PHYSICAL DEMANDS:

Ability to move freely (standing, stooping, walking, bending, pushing, and pulling) and lift up to a maximum of twenty-five (25) pounds without assistance

Job classification is exposed to blood borne pathogens (blood or bodily fluids) while performing job duties

WORK ENVIRONMENT:

Climate controlled office setting with daily movement throughout the facility

Interaction with department members and other healthcare providers

Position requires compliance with department specific competencies.

Schedule: 40 hrs/week, Flexible scheduling

Scheduled Weekly Hours:40Scheduled FTE:1Location:Corporate 100 County Road B Shawano - Shawano,WisconsinOvertime Exempt:No

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